WIHI: The Patient-Centered Medical Home: Early Results, Tough Scrutiny

Produced in collaboration with the Journal of the American Medical Association (JAMA)

Date: May 22, 2014


  • Mark Friedberg, MD, MPP, Natural Scientist, Professor, Pardee RAND Graduate School
  • Christine A. Sinsky, MD, Medical Associates Clinic and Health Plans (Dubuque, Iowa); Director, American Board of Internal Medicine
  • Don Goldmann, MD, Chief Medical and Scientific Officer, Institute for Healthcare Improvement
  • Richard Baron, MD, President and CEO, American Board of Internal Medicine, ABIM Foundation

The patient-centered medical home (PCMH) is getting a hard look this year. In a study published in JAMA in February 2014, the largest of its kind, researchers followed 32 primary care practices certified as PCMHs over a three-year period, and were unable to find any impact on overall health care costs or patients’ utilization of health care services, including emergency departments.

To put it mildly, this was not welcomed news by the health care improvement community — especially those who are looking to PCMHs as one jewel in the crown of a redesigned primary care system that offers patients more integrated, coordinated, cost-effective care. Headlines such as “Medical Homes Haven’t Saved Money or Substantially Improved Care” and “Medical Homes May Not Be The Answer” suggested just the opposite.
This is not the entire story. The state of Minnesota recently issued a report on its success with PCMHs. And, where focused work is underway elsewhere, the uptake of process improvements is encouraging. But the study in JAMA has functioned as a sort of wake-up call, which many experts, including champions of PCMHs, believe is timely and beneficial. On this WIHI, we pulled together some of these experts for an intensive look at the early results and critical next steps for the patient-centered medical home.


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